Provider Demographics
NPI:1851582670
Name:ENRIQUE PELAYO MD PA
Entity Type:Organization
Organization Name:ENRIQUE PELAYO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PELAYO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:305-554-6198
Mailing Address - Street 1:8780 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3201
Mailing Address - Country:US
Mailing Address - Phone:305-554-6198
Mailing Address - Fax:305-554-6199
Practice Address - Street 1:8780 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3201
Practice Address - Country:US
Practice Address - Phone:305-554-6198
Practice Address - Fax:305-554-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty